Quick answer. Labyrinthitis is inflammation of the inner ear, usually after a virus, causing sudden vertigo, nausea and sometimes hearing loss. It is usually self-limiting, but vertigo combined with stroke warning signs is a medical emergency – call 995.
A sudden, severe spinning sensation that leaves you nauseous and unable to walk straight can be frightening. One common cause is labyrinthitis, an inflammation of the inner ear, closely related to vestibular neuritis. Both usually follow a viral illness and settle on their own over days to weeks, though the first hours can be very unpleasant.
This guide explains what labyrinthitis is, how it differs from related conditions like Meniere’s disease and BPPV, how it is diagnosed and treated, and – most importantly – how to tell ordinary inner-ear vertigo apart from the warning signs of a stroke, which needs emergency care.
At a glance
| Condition | Typical pattern | Key feature |
|---|---|---|
| Labyrinthitis | Sudden constant vertigo lasting days | Vertigo plus hearing loss, often after a virus |
| Vestibular neuritis | Sudden constant vertigo lasting days | Vertigo without hearing loss |
| BPPV | Brief seconds-long spins with head movement | Triggered by changing head position |
| Meniere's disease | Recurrent attacks of hours | Vertigo with fluctuating hearing loss and ringing |
| Stroke (emergency) | Sudden, with other neurological signs | Weakness, slurred speech, double vision – call 995 |
What is labyrinthitis?
The labyrinth is the part of the inner ear that controls both balance and hearing. Labyrinthitis is inflammation of this structure, which disrupts the balance signals sent to the brain and can also affect hearing. A closely related condition, vestibular neuritis, affects the balance nerve only, so it causes vertigo without hearing loss.
Both are usually triggered by a viral infection, such as a cold or flu, and are most common in adults. They are not contagious in themselves. The good news is that the body usually compensates over days to weeks, so most people recover well even though the early symptoms can be alarming.
Symptoms and signs
Symptoms often come on suddenly and can be intense at first. They may include:
- Vertigo – a strong sensation that you or the room is spinning
- Nausea and vomiting
- Unsteadiness and difficulty walking or standing
- Hearing loss or muffled hearing in one ear (more typical of labyrinthitis than vestibular neuritis)
- Ringing in the ear (tinnitus)
- Difficulty focusing the eyes
Symptoms are usually worst in the first day or two and then gradually ease over the following days and weeks.
Causes and risk factors
The most common cause is a viral infection, which is why labyrinthitis often follows a cold, flu or other respiratory illness. Less commonly it can be bacterial, for example as a complication of a middle ear infection. Contributing factors and triggers include:
- A recent viral upper respiratory tract infection
- Middle ear infection (a less common bacterial route)
- Stress, fatigue and being run down
- Smoking and high alcohol intake
It can affect otherwise healthy people of any age and is not usually linked to a serious underlying problem.
How it is diagnosed
Labyrinthitis is largely a clinical diagnosis, based on the pattern of symptoms and an examination. A doctor or ENT specialist will:
- Ask about how the vertigo started, how long it lasts and any hearing change
- Examine your eyes for abnormal eye movements (nystagmus) and check your balance
- Carry out a hearing test if hearing loss is present
- Importantly, check for neurological signs to rule out a stroke or other brain cause
Scans such as an MRI are not always needed, but may be arranged if the picture is atypical or if stroke needs to be excluded.
Treatment options
Most cases settle on their own, so treatment focuses on easing symptoms and supporting recovery:
- Medication for symptoms – short-term anti-sickness and vertigo-suppressing medicines to control nausea and spinning in the first few days
- Rest and hydration during the acute phase
- Gradually returning to normal movement, as staying still for too long can slow recovery
- Vestibular rehabilitation exercises if unsteadiness lingers
- Antibiotics or antiviral treatment only in the less common cases where a bacterial cause is suspected
Recovery is usually complete, though balance can feel slightly off for a few weeks while the brain adjusts.
When to see a doctor and which specialist
See a doctor if you have sudden severe vertigo, especially with hearing loss, or if symptoms are not improving after a few days. Call 995 or go to A&E immediately if vertigo comes with any stroke warning signs, because these are NOT typical of labyrinthitis: a severe or sudden headache, weakness or numbness on one side, a drooping face, slurred speech, double vision, or difficulty walking out of proportion to the dizziness. When in doubt, treat it as an emergency and call 995.
For persistent or recurrent inner-ear vertigo, an Ear, Nose & Throat (ENT) specialist can confirm the diagnosis and arrange hearing tests and rehabilitation. You can find one through our directory of ENT specialists in Singapore.
Coping at home during the acute phase
The first day or two of labyrinthitis can be the hardest. Until the worst of the vertigo eases, it helps to rest in a quiet, dimly lit room and move your head slowly. Sip water or oral rehydration fluids regularly, especially if you have been vomiting, as dehydration can worsen how you feel. Avoid driving, operating machinery or climbing ladders while you are dizzy, and ask someone to stay with you if you feel very unsteady. Most people find symptoms gradually settle over several days; staying completely still for too long, however, can slow recovery, so begin gentle movement as soon as you are able.
Recovery and rehabilitation
While the acute spinning usually settles within a week or two, some people notice their balance feels slightly off for a few weeks longer as the brain re-adjusts. If unsteadiness lingers, your doctor may suggest vestibular rehabilitation, a set of simple eye, head and balance exercises that retrain the balance system. These are often very effective for persistent symptoms and can be taught by a physiotherapist or ENT team.
Common questions
Can labyrinthitis come back?
A single episode often does not recur, but some people have further attacks. Repeated or recurrent vertigo is worth reviewing with an ENT specialist, as it may point to a different inner-ear condition such as Meniere’s disease or BPPV.
When can I drive again?
Only drive once the vertigo has fully settled and you feel steady and able to turn your head safely. If in doubt, wait longer and check with your doctor.
Related guides
- Best ENT Clinics in Singapore — our editorial shortlist
- ENT clinics directory
- Chronic sinusitis
- Perforated eardrum
- Glue ear
- Vocal cord nodules
- Uterine prolapse
Sources
- NHS – Labyrinthitis and vestibular neuritis
- HealthHub Singapore – Giddiness and vertigo
- Mayo Clinic – Vertigo (dizziness)
- SingHealth – Dizziness and Vertigo
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